• Title/Summary/Keyword: 견관절 골절

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Review in Remplissage on Anterior Shoulder Instability with Huge Hill-Sachs Lesion (전방 견관절 불안정성의 Hill-Sachs 병변의 치료에서 Remplissage의 Review)

  • Ko, Sang-Hun;Lee, Chae-Chil;Park, Han-Chang
    • Clinics in Shoulder and Elbow
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    • v.14 no.1
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    • pp.134-139
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    • 2011
  • Purpose: We wanted to review the arthroscopic Remplissage technique and introduce our experiences with it for treating recurrent shoulder instability with a large Hill-Sachs lesion. Materials and Methods: The arthroscopic Remplissage technique with Bankart repair is performed in patients with no osteoarthritis, no fracture around the shoulder, a history of recurrence more than 10 times, a large Hill-Sachs lesion more than 30 to 40% of the humeral articular surface and glenoid bone loss less than 20%. Results and Conclusion: For recurrent shoulder instability with a large Hill-Sachs lesion, the Remplissage technique resulted in a good outcome for the shoulder stability, and good clinical and functional results.

The Operative Treatment of Scapular Glenoid Fracture (견갑골 관절와 골절의 수술적 치료)

  • Kang, Ho-Jung;Jung, Sung-Hoon;Jung, Min;Hahn, Soo-Bong;Kim, Sung-Jae;Kim, Jong-Min
    • Clinics in Shoulder and Elbow
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    • v.10 no.2
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    • pp.212-219
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    • 2007
  • Purpose: To determine the causes of the surgical treatment results in glenoid fracture by a retrospective analysis. Materials and methods: From March 1999 to February 2004, 9 patients who underwent an open reduction due to a glenoid fracture were reviewed. The modified Ideberg classification was used. There were 1, 3, 2, 1 and 2 cases of modified Ideberg type I, II, III, V, and VI, respectively. The internal fixators were a reconstruction plate, a small plate, a one-third tubular plate, a small screw, and a cannulated screw in 6, 1, 3, 3 and 1 case, respectively. The constant score and Adam's functional assessment method were used to evaluate the postoperative shoulder function. Results: The average time for fracture union was 7 weeks. The functional assessment was excellent in 4 cases, good in 3 cases, and fair in 2 cases. There were two complications related to surgery; articular screw encroachment, and inferior glenoid bone resorption without instability. Conclusion: A glenoid fracture with glenohumeral instability or displaced that was treated by open surgery showed good clinical results. Moreover, the more comminuted fracture had a lower functional score.

Arthroscopic Treatment of Greater Tuberosity fracture - Preliminary Report - (상완골 대결절 골절 손상에 대한 관절경적 치료 -예비 보고-)

  • Ji, Jong-Hoon;Kim, Young-Yul;Park, Sang-Eun;Ra, Ki-Hang;Do, Jeong-Hun;Kim, Weon-Yoo
    • Journal of Korean Orthopaedic Sports Medicine
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    • v.6 no.1
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    • pp.57-65
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    • 2007
  • Purpose: The purpose of this study was to evaluate the clinical result of arthroscopic treatments by using suture anchors or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture. Materials and Methods: From March 2004 to March 2006 we have used suture anchor or suture anchors combined with cannulated screw for 6 cases of the greater tuberosity fracture which include displaced fractures, comminuted fractures and minimally displaced fractures with comcomittent lesions such as rotator cuff tears, stiffness and labral lesion. In this retrospective study, we analyzed the clinical outcomes by using the range of motion, University of California at Los Angeles shoulder rating scale (UCLA) and the ASES shoulder index score (ASES) in the average 6 months follow up. Results: At the last follow up, average range of motion was improved to 154.3 degree, 145.8 degree, 32.6 degree and L1 vertebrae in each forward flexion, abduction, external rotation and internal rotation. Clinically the UCLA rating scales improved to 31.5 and the ASES shoulder index score (ASES) improved to 93.6 in the last follow up. Conclusion: Arthroscopic treatments by using suture anchor or suture anchors combined with cannulated screw in the greater tuberosity fracture of the proximal humerus fracture is an alternative treatment of the greater tuberosity fracture of the proximal humerus fracture.

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Operative Treatment of the Displaced Midshaft Clavicle Fracture Using Precontoured Locking Compression Plate (Precontoured Locking Compression Plate를 이용한 전위성 쇄골 간부 골절의 수술적 치료)

  • Kim, Jeong Woo;Kang, Hong Je;No, Sung Hyun
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.117-122
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    • 2012
  • Purpose: To assess the effectiveness of internal fixation using a precontoured locking compression plate for the treatment of the displaced clavicle fracture by analyzing both radiological and clinical outcomes. Materials and Methods: We reviewed 34 cases of displaced clavicle shaft fracture treated by internal fixation using precontoured locking compression plates between May 2009 and February 2010. Radiological outcomes were analized on the basis of bone union and the differences between the time for bone union depending on sex and age. Clinical outcomes were analyzed on the basis of quick DASH Scores and the differences in the range of motion of the affected shoulder compared to the contralateral shoulder. Results: In the radiological evaluation, all fractures showed bone union, and the average time for bone union was 12.3 weeks, without delayed unions. Time for bone union did not differ significantly with respect to sex and age (p=0.87). In the clinical evaluation, the average final quick DASH Score was 23.5 (range, 12~42). At final follow up, the range of motion after bone union in the affected shoulder was not significantly different from that of the contralateral shoulder (p=0.69). Conclusion: The internal fixation achieved using precontoured locking compression plate in displaced clavicle shaft fracture showed effective bone union and can be considered as a reliable method with fine clinical results showing early range of motion at the shoulder joint.

Non-displaced Acromial Fracture diagnosed early by the Ultrasonography (초음파로 조기 진단한 비전위 견봉 골절)

  • Song, Hyun-Seok;Kim, Do-Hoon;Kim, Ryul;Choi, Nam-Yong
    • The Journal of Korean Orthopaedic Ultrasound Society
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    • v.5 no.1
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    • pp.46-49
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    • 2012
  • Diagnoses of the acromial fractures are frequently delayed because most acromial fractures are non-displaced or minimally displaced patterns and the frequency are low. We report a case that a non-displaced acromial fracture of 74 years old male hit by the falling pipes could be diagnosed by the ultrasonography. For this case who had a pain, swelling, and the limitation of active elevation of the left shoulder after direct injury, the evaluation about the rotator cuff and the biceps long head tendon was required but the early diagnosis of the non-displaced acromial fracture was done by the easier ultrasonography before the additional studies. The ultrasonography has the advantage over the computed tomography in the aspect of evaluating the injury of the tendons of the shoulder joint.

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Triple Disruption of the Superior Shoulder Suspensory Complex - Case Report at 5-year-follow up - (상부 견갑 현수 복합체의 3중 붕괴 - 5년 추시 증례 보고 -)

  • Sung, Chang-Meen;Park, Hyung Bin
    • Clinics in Shoulder and Elbow
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    • v.15 no.2
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    • pp.143-147
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    • 2012
  • A triple disruption of the SSSC, an extremely rare injury, has been reported by only a few authors. We present a patient who had sustained a triple disruption of the SSSC: coracoid and scapular spine fractures, and an acromioclavicular joint separation. Treatment consisted of an anatomical restoration of the SSSC, with maintenance of the acromiohumeral and coracohumeral distances; this was achieved by open reduction and internal fixation of the fractures and of the separation. Six months after surgery, the injured shoulder was asymptomatic, with full range of motion. Five years after surgery, at the final follow-up, the function of the SSSC had been restored to the patient's complete satisfaction.

Minimal Invasive Plate Osteosynthesis in Proximal Humerus Fractures (상완골 근위부 골절에서의 최소 침습적 금속판 술식)

  • Shin, Sang-Jin;Do, Nam-Hun;Song, Mi-Hyun;Sohn, Hoon-Sang
    • Clinics in Shoulder and Elbow
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    • v.13 no.2
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    • pp.202-208
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    • 2010
  • Purpose: In this study we introduced minimal invasive plate osteosynthesis (MIPO) and analyzed clinical outcomes to determine the effectiveness of this intervention in proximal humerus fractures. Materials and Methods: We studied 27 patients including 16 cases with a 2-part fracture, 10 cases with a 3-part fracture, and 1 case with a 4-part fracture. Clinical outcomes were evaluated using UCLA score, KSS score and recovery of range of motion. Time to union and humerus neck-shaft angle change were estimated by radiologic assessment. The average follow up period was 19 months. Results: UCLA scores were "excellent" for 15 patients, "good" for 12 patients. The mean KSS score was 91.4 at final follow-up. The average shoulder range of motion was $167.2^{\circ}$ in forward elevation. Bone union occurred by 14.1 weeks postoperatively. Humerus neck-shaft angle recovery was "excellent" in 24 patients and "moderate" in 3 patients. There were no complications such as axillary nerve paralysis, deep infection, or subacromial impingement of the plate. Conclusion: MIPO for proximal humerus fractures is an effective procedure if performed with sufficient understanding of the anatomical structures. MIPO leads to minimized dissection of soft tissue, low complication rates and early recovery of range of motion.

Application of Hinged Transarticular External Skeletal Fixator (HTAESF) for Proximal Tibial Physeal Fracture in a Dog (개의 근위 경골 성장판 골절에서 경첩 관절경유 외고정의 적용)

  • Kim, Kwan;Heo, Su-Young;Lee, Hae-Beom
    • Journal of Veterinary Clinics
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    • v.29 no.6
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    • pp.502-505
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    • 2012
  • An 8-month-old, 3.5 kg intact female Toy Poodle was presented for non-weight-bearing lameness on left hindlimb. In radiological testing, left proximal tibal type II Salter-Harris physeal fracture and fibular fracture were seen. Following open reduction, the fracture was stabilized with cross-pins, tension band wires, and a hinged transarticular external skeletal fixator (HTAESF). The range of the HTAESF was increased to $25^{\circ}$ at 7 days postsurgery and to $70^{\circ}$ at 14 days post-surgery. The HTAESF was removed 3 weeks after surgery. At 6 weeks post-surgery, the fracture was successfully healed with no complications and the patient recovered a normal gait. Seven months post-surgery, the patient had a normal gait and a normal stifle joint range of motion compared to the contralateral normal limb. This is a case in which the combined use of cross-pins, tension band wires, and HTAESF was successful for treatment of a proximal tibial physeal fracture in a dog. It is thought that these methods are beneficial for stability of fracture site and recover of joint's normal range of motion through early joint movement.

Treatment of Type 2 Distal Clavicle Fracture using Wolter Plate (Wolter 금속판를 이용한 제 2형 원위부 쇄골 골절의 치료)

  • Shin, Sung-Il;Song, Kyung-Won;Lee, Jin-Young;Lee, Seung-Yong;Kim, Gab-Rae;Hyun, Yoon-Suk;Lee, Kwang-Nam;Lee, Eun-Soo
    • Clinics in Shoulder and Elbow
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    • v.12 no.1
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    • pp.14-20
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    • 2009
  • Purpose: This study examined the clinical results of the treatment of type 2 distal clavicle fracture with using a Wolter plate. Materials and Methods: Between 2004 and 2007, 16 patient treated for type 2 distal clavicle fracture using a Wolter plate were included in this study. Their average age was 32.6 years and the postoperative mean follow-up period was 22.9 months. The reduction and union were qualified according to the immediate post-operative and final radiographs. The functional outcome was evaluated by Kona's system and the Constant score Results: By Kona's functional evaluation, there were 12 cases with excellent results, 3 cases with good results and 1 case of fair results and the average Constant score was 90. All 16 cases showed bony union. As complications, there was 1 case in which the protruded hook of the plate could be palpated at the skin, and 1 case showed an acromial fracture, but all the cases dispalyed successful bony union and there was no acromioclavicular joint arthritis, infection or any other complications. Conclusion: Wolter plate fixation for type 2 distal clavicle fracture is a reliable surgical method for satisfactory reduction and rigid fixation, a lower incidence of nonunion and excellent clinical result.